Dengue antibodies can cross-react with SARS-CoV-2 and <i>vice versa</i>-Antibody detection kits can give false-positive results for both viruses in regions where both COVID-19 and Dengue co-exist

Nath, Himadri; Mallick, Abinash; Roy, Subrata; Sukla, Soumi; Basu, Kalyani Saha; De, Alok; Biswas, Subhajit

doi:10.1101/2020.07.03.20145797

Cited by 24 publications

(30 citation statements)

References 5 publications

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“…According to different authors, cross-reactivity with other seasonal coronavirus, such as E229, OC43, HKU1, and NL63, was not observed when COVID-19 serum samples were tested by Abbott Laboratories SARS-CoV-2 IgG CMIA [ 21 – 23 ]. Occurrence of cross-reactivity between Dengue and SARS-CoV-2 antibodies [ 10 , 12 , 24 ], was not corroborated by results presented here as well as from other authors [ 25 ]. We demonstrated that all 84 (100%) Dengue-positive samples, collected between 2009 and 2010, tested negative for the presence of anti-SARS-Cov-2 IgG ( Table 1 ; Fig 4 ).…”

Section: Discussioncontrasting

confidence: 69%

“…Additionally, no correlation between SARS-CoV-2 IgG immunoreactivity index and either days-post-symptom onset or age was found ( Fig 3A and 3B ). To exclude the possibility that the observed SARS-CoV-2 positive results were due to cross-reactivity with Dengue antibodies, as reported elsewhere [ 10 , 12 ], a panel of pre-pandemic samples originated from a 2009−2010 Dengue outbreak in the state of Espírito Santo, including paired acute and convalescent phase sera from 42 Dengue fever patients ( Table 1 ), was evaluated by CMIA. All 84 samples were negative for anti-SARS-CoV-2 IgG ( Fig 4A and 4B ), excluding the possibility of result misinterpretation caused by false-positive reactions.…”

Section: Resultsmentioning

confidence: 99%

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Covert cases of Severe Acute Respiratory Syndrome Coronavirus 2: An obscure but present danger in regions endemic for Dengue and Chikungunya viruses

et al. 2021

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Background The impact of SARS-CoV-2 in regions endemic for both Dengue and Chikungunya is still not fully understood. Considering that symptoms/clinical features displayed during Dengue, Chikungunya and SARS-CoV-2 acute infections are similar, undiagnosed cases of SARS-CoV-2 in co-endemic areas may be more prevalent than expected. This study was conducted to assess the prevalence of covert cases of SARS-CoV-2 among samples from patients with clinical symptoms compatible with either Dengue or Chikungunya viral infection in the state of Espírito Santo, Brazil. Methods Presence of immunoglobulin G (IgG) antibody specific to SARS-CoV-2 nucleoprotein was detected using a chemiluminescent microparticle immunoassay in samples from 7,370 patients, without previous history of COVID-19 diagnosis, suspected of having either Dengue (n = 1,700) or Chikungunya (n = 7,349) from December 1st, 2019 to June 30th, 2020. Findings Covert cases of SARS-CoV-2 were detected in 210 (2.85%) out of the 7,370 serum samples tested. The earliest undiagnosed missed case of COVID-19 dated back to a sample collected on December 18, 2019, also positive for Dengue Virus. Cross-reactivity with either Dengue virus or other common coronaviruses were not observed. Interpretation Our findings demonstrate that concomitant Dengue or Chikungunya outbreaks may difficult the diagnosis of SARS-CoV-2 infections. To our knowledge, this is the first study to demonstrate, with a robust sample size (n = 7,370) and using highly specific and sensitive chemiluminescent microparticle immunoassay method, that covert SARS-CoV-2 infections are more frequent than previously expected in Dengue and Chikungunya hyperendemic regions. Moreover, our results suggest that SAR-CoV-2 cases were occurring prior to February, 2020, and that these undiagnosed missed cases may have contributed to the fast expansion of SARS-CoV-2 outbreak in Brazil. Data presented here demonstrate that in arboviral endemic regions, SARS-CoV-2 infection must be always considered, regardless of the existence of a previous positive diagnosis for Dengue or Chikungunya.

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Section: Discussioncontrasting

confidence: 69%

Section: Resultsmentioning

confidence: 99%

Covert cases of Severe Acute Respiratory Syndrome Coronavirus 2: An obscure but present danger in regions endemic for Dengue and Chikungunya viruses

et al. 2021

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“…In countries like Brazil, where dengue fever and other arboviruses are endemic problems, the possibility of cross-reactions with SARS-CoV-2 could be a challenge ( Nath et al, 2020 ; Yan et al, 2020 ; Lustig et al, 2020 ; Lorenz et al, 2020 ). Although these arboviruses do not cause respiratory disease, they can be difficult to distinguish from COVID-19 as both can elicit similar extra-pulmonary manifestations such as fever, cutaneous rash and conjunctivitis.…”

Section: Discussionmentioning

confidence: 99%

Nucleoprotein-based ELISA for detection of SARS-COV-2 IgG antibodies: Could an old assay be suitable for serodiagnosis of the new coronavirus?

Tozetto‐Mendoza

Kanunfre

Vilas-Boas

et al. 2021

Journal of Virological Methods

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“…This year a few reports have indicated the occurrence of serological crossreactivity between dengue fever and COVID-19 [34][35][36][37]. For instance, Lustig et al…”

Section: Discussionmentioning

confidence: 99%

How super-spreader cities, highways, hospital bed availability, and dengue fever influenced the COVID-19 epidemic in Brazil

Nicolelis

Raimundo

Peixoto

et al. 2020

Preprint

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Although its international airports served as the country's main entry points for SARS-CoV-2, the factors driving the uneven geographic spread of COVID-19 cases and deaths in Brazil remain largely unknown. Here we show that four major factors likely accounted for the entire dynamics of COVID-19 in Brazil. Mathematical modeling revealed that, initially, the "super-spreading" city of São Paulo accounted for roughly 80% of the case spread in the entire country. During the first 3 months of the epidemic, by adding only 16 other spreading cities, we accounted for 98-99% of the cases reported in Brazil at the time. Moreover, 26 of the major Brazilian federal highways accounted for about 30% of SARS-CoV-2's case spread. As cases accumulated rapidly in the Brazilian countryside, the distribution of COVID-19 deaths began to correlate with a third parameter: the geographic distribution of the country's hospital intensive care unit (ICU) beds, which is highly skewed towards state capitals where the epidemic began. That meant that severely ill patients living in the countryside had to be transported to state capitals to access ICU beds where they often died, creating a "boomerang effect" that contributed to the skew of the geographic distribution of COVID-19 deaths. Finally, we discovered that the geographic distribution of dengue fever, amounting to more than 3.5 million cases from January 2019 to July 2020, was highly complementary to that of COVID-19. This was confirmed by the identification of significant negative correlations between COVID-19's incidence, infection growth rate, and mortality to the percentage of people with antibody (IgM) levels for dengue fever in each of the country's states. No such correlations were observed when IgM data for chikungunya virus, which is transmitted by the same mosquito vector as dengue, was used. Thus, states in which a large fraction of the population had contracted dengue fever in 2019-2020 reported lower COVID-19 cases and deaths, and took longer to reach exponential community transmission, due to slower SARS-CoV-2 infection growth rates. This inverse correlation between COVID-19 and dengue fever was further observed in a sample of countries around Asia and Latin America, as well as in islands in the Pacific and Indian Oceans. This striking finding raises the intriguing possibility of an immunological cross-reactivity between DENV serotypes and SARS-CoV-2. If proven correct, this hypothesis could mean that dengue infection or immunization with an efficacious and safe dengue vaccine could produce some level of immunological protection for SARS-CoV-2, before a vaccine for SARS-CoV-2 becomes available.

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Dengue antibodies can cross-react with SARS-CoV-2 and vice versa-Antibody detection kits can give false-positive results for both viruses in regions where both COVID-19 and Dengue co-exist

Cited by 24 publications

References 5 publications

Covert cases of Severe Acute Respiratory Syndrome Coronavirus 2: An obscure but present danger in regions endemic for Dengue and Chikungunya viruses

Covert cases of Severe Acute Respiratory Syndrome Coronavirus 2: An obscure but present danger in regions endemic for Dengue and Chikungunya viruses

Nucleoprotein-based ELISA for detection of SARS-COV-2 IgG antibodies: Could an old assay be suitable for serodiagnosis of the new coronavirus?

How super-spreader cities, highways, hospital bed availability, and dengue fever influenced the COVID-19 epidemic in Brazil

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